Scope
Introduction
At a number of locations abroad, the standards of medical care and the extent of treatment facilities or specialist services are inadequate in comparison with those in Canada. Additionally, at several locations, while adequate health care/facilities exist, treatment costs are excessive. This directive is designed to ensure that an employee and/or dependant have access to necessary and suitable health care facilities and services on a cost-effective basis as determined by the deputy head.
Issue and verification procedures are found in FSD 70 – Reporting requirements and verification of allowances.
Definitions
Note: These definitions only apply to this directive.
Dependant (personne à charge) means each dependant or dependent student, as defined in FSD 2 - Definitions respectively, who resides with the employee at the post, or is in full-time attendance at an educational institution outside of Canada.
Living expenses (frais de subsistance) means:
(a) actual and reasonable local transportation expenses to and from the treatment centre, and
(b) actual and reasonable living expenses in commercial accommodation, or
(c) the cost of board, lodging and laundry in private accommodation, at a maximum of the Private Non-Commercial Accommodation Allowance in accordance with the NJC Travel Directive;
(d) the cost of telephone calls between the location of the person on health care travel and the family members at the employee's post, up to the cost of one ten-minute direct dialed long distance telephone call per week from the location of the person on health care travel to the employee's post for the total period of health care travel.
Directive
41.1 Application
41.1.1 The health care facilities or services referred to in this directive may include dental care, only for those posts listed in Appendix A to FSD 9 - Medical and Dental Examinations, and published on the Department of Foreign Affairs and International Trade's website, and reasonable para-medical care.
41.1.2 The deputy head shall determine the suitability of health care facilities by reference to the advice of a roster doctor, an official of Health Canada or other qualified medical practitioner. An assessment of the suitability of treatment centres should also take into account cultural, social and political factors.
41.1.3 Where the deputy head is satisfied that necessary and suitable health care facilities or services are not available locally, or local treatment costs exceed costs of travel, treatment and living expenses at the nearest suitable location, another suitable location, or Canada, the following may be approved:
(a) travel leave for the employee,
(b) payment of actual and reasonable travelling expenses, including the lowest available airfare appropriate to a particular circumstance and/or itinerary which could include a higher standard of travel, during travelling time for an employee or dependant, and/or a young child who is obliged to accompany a parent on health care travel, and, where the need is certified by a qualified medical practitioner, for an escort, between the location of the employee or a dependant and the nearest suitable place as determined by the deputy head; or where the employee so requests, Canada or another suitable place where the required health care is available on a cost-effective basis, as determined by the deputy head,
(c) actual and reasonable living expenses during outpatient treatment for the employee or a dependant, and/or a young child who is obliged to accompany a parent on health care travel, and, where the need is certified by a qualified medical practitioner, for an escort,
(d) actual and reasonable living expenses for an escort, where the need is certified by a qualified medical practitioner and, where the employee or a dependant is receiving inpatient treatment and it is either desirable or more economical to have the escort remain at the treatment centre for the duration of the treatment period,
(e) travelling expenses may be paid for an escort to make a second trip to and from the treatment centre at the conclusion of the treatment period, where it is not necessary for the escort to remain with the person being treated,
(f) payment of dependant care expenses incurred by employees who are single parents or whose spouses or common-law partners accompany them on health care travel, where expenses are paid for dependant(s) under 18 years of age who reside permanently with the employee at the post where these are in excess of any existing permanent child care arrangements, such that the employee shall be reimbursed actual and reasonable dependant care expenses up to the provisions of the NJC Travel Directive. Where expenses for dependant care are incurred at a post, the maximum amount may be exceeded on the recommendation of the appropriate foreign service interdepartmental co-ordinating committee.
41.1.4 Subject to paragraphs 41.1.3(b) and (c), when approving payment of travelling and living expenses for accompanying dependent children on health care travel, the deputy head shall consider each case on its own merits taking into account such factors as the ages of the children accompanying the parent and the availability and cost of child-care services at the post.
41.1.5 Dependant care assistance shall not be provided when the child's other parent resides in the same location as the child who requires dependant care.
41.2 Travel Leave
41.2.1 Unless the deputy head otherwise directs, travel leave shall only be granted during normal working hours where it is not feasible for the employee to travel during non-working hours.
41.3 Accouchement
41.3.1 In cases of accouchement, where payment of actual and reasonable travelling expenses has been authorized under subsection 41.1.3 for an employee and/or a dependant who travels to the nearest suitable place; or where the deputy head determines it is cost-effective and the employee so requests, to Canada or another suitable place where accouchement may take place, the deputy head may also approve:
(a) the payment of actual and reasonable living expenses both before and after the time of delivery where:
(i) the visa or other re-entry regulations delay the return to the post; and/or
(ii) the common carrier approved by the deputy head to provide the most suitable and appropriate means of transportation requires that such travel take place prior to the expected date of delivery; and/or
(iii) there is a medical requirement acceptable to Health Canada;
(b) an allowance for travelling expenses and living expenses, subject to FSD 70 Reporting Requirements and Verification of Allowances, for a period not to exceed five days, in accordance with subsection 41.1.3, to enable the spouse or common-law partner to be present at the birth of the child.
41.4 Report to Health Canada
41.4.1 When health care travel is authorized under this directive, a medical report from the attending physician, acceptable to Health Canada, must be sent to:
Medical Officer in Charge
Occupational Health Clinic
Public Service Health Program
Emergency Preparedness and Occupational Health Directorate
Regions and Program Branch
Health Canada
171 Slater Street, 12th Floor, P.L. 3712M
Ottawa, ON K1A 0K9